Expanded Adult Day Program as a Transition Option From Hospital to Home

Abstract

This article describes a pilot program for provision of postacute care (PAC) in an established adult day program. Demographic, clinical, utilization, and satisfaction data were abstracted retrospectively from program records; postdischarge readmission and emergency department visit data were obtained from the electronic health record. Comparative data were obtained from the health records of patients who were offered but declined the adult day program. Between 2005 and 2008, 78 patients requiring PAC were approached by the RN coordinator; 33 selected the adult day program, and 45 selected alternative destinations. The majority of patients had a neurological diagnosis, most commonly stroke. Participants and their family caregivers were highly satisfied with the program. The 30-day readmission rate for adult day program participants was significantly lower than that for nonparticipants. An expanded adult day program may represent a viable Transitional Care Model for selected patients and a feasible alternative to skilled nursing facility and home health care for PAC.

The Effectiveness of Adult Day Services for Older Adults

“…Work of the last 10 years seems to suggest that ADS actually acts as a stepping stone to institutionalization for spousal caregivers but can prevent or delay institutionalization when the primary caregiver is an adult child (see Cho et al, 2009; McCann et al, 2005). New to the literature are efforts to examine the impact of ADS on other costly health care utilization including post-acute care and rehospitalization (Jones et al, 2011). However, moving forward, the question remains: What elements of the ADS experience make a difference?…”

The State of Adult Day Services

“…Given the population served, the professional staff employed, and the care offered, further research regarding the role ADS providers play in care coordination and transitions is needed. Some of the most promising studies around the impact of ADS on the costs of care focus on the role ADS can play in reducing emergency room visits and re-hospitalization (Jones et al, 2011). Larger scale replication studies of this work could shed light on the cost efficiencies of ADS with the spectrum of long-term care.…”